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Health / Outgoing NHS chief sets out challenges ahead

THE OUTGOING chief executive of NHS Shetland has set out the challenges his successor will have to tackle as the local health board tries to find better ways of delivering services over the coming years.

After eight and half years at the helm of the Shetland health board, Ralph Roberts attended his last board meeting on Tuesday before starting his new job as the chief executive of NHS Borders on Easter Monday.

Paying tribute to his staff and the welcoming local community, he said Shetland continued to enjoy a “really good quality service” despite the challenges.

“You get very insular in terms of what goes on here, and it is only when you travel south and speak to colleagues that you realise that whatever our challenges are we are in a very different place, and I think sometimes the community does not recognise that,” he said.

For many years now health service redesign, including the integration of health and care services across the isles, but also the introduction of advanced nurse practitioners at Lerwick Health Centre, has been high on the agenda.

Roberts said the service redesign work would have to continue while NHS Shetland tries to live within a tight budget. That, he said, requires commitment and creativity, and will be a big job for whoever is to be appointed to lead the health board into the next decade.

“We are projecting for this year that we will break even but that requires that we identify a level of savings and that will be challenging to deliver,” he said.

“But looking at the next three to four years, we will have to make significant changes to our services and there are a number of reasons; partly financial, partly because demands on our services is changing, but also because populations are changing and new technology is coming in.

“The budget goes up but the pressures on the service go up by more, hence the need to redesign so that you can deliver more with less in real terms.

“You can do a lot of things where you end up with a better services that doesn’t cost you necessarily more money, and in certain circumstances cost you even less money.

“And that requires us to work with the community, and for the community not to become focused with assuming the way the service is delivered now is the way the service should be all the time.”

Chief officer of Shetland’s health and social care partnership Simon Bokor-Ingram has been appointed interim chief executive until a new permanent staff member has been appointed.